Cancer Treatment Centers of America

Stage IV head and neck cancer

Stage IVA: One of the following applies:

  • T4a, N0 or N1, M0: The head and neck cancer tumor is any size and is growing into nearby structures. Cancer cells may not be present in the lymph nodes, or they may have spread to one lymph node, which is located on the same side of the head or neck as the primary tumor and is smaller than 3 cm across. Cancer has not spread to distant sites.

Or

  • T1-4a, N2, M0: The tumor is any size and may or may not have invaded nearby structures. It has not spread to distant sites, and one of the following is true:
    • Cancer cells are present in one lymph node, located on the same side of the head or neck as the primary tumor and measuring 3-6 cm across (N2a).
    • Cancer cells are present in one lymph node on the opposite side of the head or neck and measuring less than 6 cm across (N2b).
    • Cancer cells are present in two or more lymph nodes, all smaller than 6 cm across and located on either side of the head or neck (N2c).

Stage IVB: One of the following applies:

  • T4b, any N, M0: The tumor has invaded deeper areas and/or tissues. It may or may not have spread to lymph nodes and has not spread to distant sites.

Or

  • Any T, N3, M0: The tumor is any size and may or may not have grown into other structures. It has spread to one or more lymph nodes larger than 6 cm across, but has not spread to distant sites.

Stage IVC:

Any T, Any N, M1: The head and neck cancer tumor is any size and may or may not have spread to the lymph nodes. Cancer cells have spread to distant sites.

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